在患有持续性心房的患者中,进行前移除率控制疗法和直接导管移除:DECAAF II亚分析
Radia Ksayer1, Hadi Younes1, Eli Tsakiris1
1Tulane Research Innovation for Arrhythmia Discovery, New Orleans, 1430 Tulane Avenue, LA, 70112, USA.
概括
对于持久性心房动 (PersAF),在没有先前使用diltiazem或metoprolol等速率控制药物的情况下开始导管切除与首先使用这些药物一样有效. 这种方法在AF复发,纤维化或生活质量方面没有显著差异.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗干预 医疗干预
背景情况:
- 持久性心房动 (PersAF) 管理通常涉及在导管切除之前的速率或节律控制.
- 本研究探讨了前剥离率控制对结果的影响.
研究的目的:
- 为了比较DTCA与使用diltiazem或metoprolol的速率控制后的移除.
- 评估前移除β阻塞剂 (美托普罗罗尔) 和通道阻塞剂 (diltiazem) 对移除后心房的复发,纤维化和生活质量的影响.
主要方法:
- 分析了两组接受导管切除的PersAF患者队列.
- 评估结果包括18个月的心房复发,左心房纤维化 (LGE MRI) 和生活质量 (SF-36).
- 统计分析包括卡普兰-梅尔曲线,威尔科克森测试和多变量考克斯模型.
主要成果:
- 在DTCA和先前使用美托普罗罗尔或迪尔提阿泽姆之间,没有发现AF复发的显著差异.
- 除去前的美托普罗罗尔或迪尔提阿泽姆并没有独立预测AF复发.
- 两组之间没有观察到纤维化或生活质量的显著差异.
结论:
- 用迪尔提亚泽姆或美托普罗罗尔进行前移除率控制,对于接受导管移除的PersAF患者没有任何额外的益处.
- DTCA是一种可行的策略,其结果与降息后的降息结果相似.
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